NAD+ in COVID-19 and viral infections

Minyan Zheng, Michael B. Schultz, and David A. Sinclair

Published February 10, 2022 in Opinion - Trends in Immunology - Volume 43, issue 4, P283-295, April 01, 2022

Subject covered by this article:
NAD+, as an emerging regulator of immune responses during viral infections, may be a promising therapeutic target for coronavirus disease 2019 (COVID-19). In this Opinion, we suggest that interventions that boost NAD+ levels might promote antiviral defense and suppress uncontrolled inflammation. We discuss the association between low NAD+ concentrations and risk factors for poor COVID-19 outcomes, including aging and common comorbidities. Mechanistically, we outline how viral infections can further deplete NAD+ and its roles in antiviral defense and inflammation. […] Finally, we explore ongoing approaches to boost NAD+ concentrations in the clinic to putatively increase antiviral responses while curtailing hyperinflammation.” (bold added)


  • “…NAD+ can exert both antiviral and anti-inflammatory effects in mice and humans, which might be beneficial during coronavirus disease 2019 (COVID-19) infections.” (bold added)
  • “Compared with healthy individuals, NAD+ concentrations in tissues and organs are lower in older individuals and in patients with diseases associated with severe COVID-19 symptoms, including diabetes and cardiovascular disease.”
  • “Viral infections, including coronavirus infections, have been reported to further deplete cellular NAD+ stores.”
  • “Many NAD+-dependent enzymes, including members of the sirtuin and poly-ADP-ribose polymerase (PARP) families, display potent antiviral activities.”
  • “Several NAD+-boosting compounds and molecules that target NAD+-producing or -consuming enzymes are in clinical development as putative anti-inflammatory or antiviral drugs.”

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